Cancelation of Jeopardy

Cancel

100

POINTS

POINTS

200

How many days after signature on a plan can a member still cancel their plan ?

14 days

300

Take a break, Here's 300pts

Winner Winner Chicken Dinner!

400

what are the two-time frames members can cancel their enrollment?

Prior to effective date or 14 days from the signature date of application

500

When submitting an Ember Ticket, what is the category that needs to be selected? 

Medicare Eligibility

My

100

True or False

If a members Wife is calling to cancel her Husbands' Plan, you can submit the cancelation request since they are married?

False

Only the Member or POA can cancel the members' plan

200

Wrong Disposition used, lose 200pts

sorry

300

What are some Marketing Misrepresentation keywords members might say?

• I was not informed.
• Nobody told me that.
• I was told differently.
• This was not explained.
• I did not enroll.
• I was told that my insurance changed to Wellcare, I was not aware.
• I went to the pharmacy, and I was advised that I have Wellcare, I did not know that.
• They said this is the copay, I was told differently.
• This benefit was not explained to me.

400

In Omni, how many days is the process for a Cancelation request?

3-5 business days

500

Where can agents locate the PBP code in OMNI when submitting an Ember Ticket?

PBP is located in Plan Information

 "only need last 3 digits"

PBP= coverage code

Plan

100

What must also be submitted on all calls when submitting a cancelation?

a Grievance

200

Do you file a Grievance in OMNI or in an Ember Ticket?

File a Grievance in OMNI

300

If a member wants to review prescription copays, what are to two ways agents can get into the CSP platform (Express Scripts)

1. clicking on the "CSP" button in Sensentia.

2. In Centralpoint, using the link in "Medicare Advantage Links" labeled "Customer Service Platform(CSP)

https://cenpointprd.ad.wellcare.com/articles/56556956-1fd3-4cf0-b70a-b48675e9c00c

400

Alex Trebek Question

What is, would you rather win 300pts, or take 400pts away from the other team?

.......

500

When submitting an Ember ticket, a Segment ID needs to be inputted. What is the Segment ID labeled as in OMNI?

Segment ID= is contract ID 

'Last 3 numbers, if blank enter 000"

ex: H7173-002

Please

100

True or False

An AOR can cancel a members' plan if they are unsatisfied?

False

AORs do not have the ability to make changes to information on file (address, PCP, phone number, etc.).

200

What is the Call Driver you would use in CareConnect's to cancel a plan?

Cancellation of Enrollment

300

Swap points

Ha

400

When submitting a request for cancelation, how many days will the member receive a letter in the mail acknowledging their request?

up to 30 days.

500

What is the name of the notes in CareConnect's that shows the date a member has to cancel their enrollment?

OB2 note, when they can cancel